Current status and outcomes of direct oral anticoagulant use in real-world atrial fibrillation patients—fushimi af registry ―

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  • Yamashita Yugo
    Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
  • Uozumi Ryuji
    Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine
  • Hamatani Yasuhiro
    Division of Heart Failure, National Cerebral and Cardiovascular Center
  • Esato Masahiro
    Department of Arrhythmia, Ijinkai Takeda General Hospital
  • Chun Yeong-Hwa
    Department of Arrhythmia, Ijinkai Takeda General Hospital
  • Tsuji Hikari
    Tsuji Clinic
  • Wada Hiromichi
    Division of Translational Research, National Hospital Organization Kyoto Medical Center
  • Hasegawa Koji
    Division of Translational Research, National Hospital Organization Kyoto Medical Center
  • Ogawa Hisashi
    Department of Cardiology, National Hospital Organization Kyoto Medical Center
  • Abe Mitsuru
    Department of Cardiology, National Hospital Organization Kyoto Medical Center
  • Morita Satoshi
    Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine
  • Akao Masaharu
    Department of Cardiology, National Hospital Organization Kyoto Medical Center

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タイトル別名
  • Current Status and Outcomes of Direct Oral Anticoagulant Use in Real-World Atrial Fibrillation Patients　― Fushimi AF Registry ―

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抄録

<p>Background:The current status and outcomes of direct oral anticoagulant (DOAC) use have not been widely evaluated in unselected patients with atrial fibrillation (AF) in the real world.</p><p>Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical institutions (n=80) in Fushimi, Kyoto, Japan. Follow-up data with oral anticoagulant (OAC) status were available for 3,731 patients by the end of November 2015. We evaluated OAC status and clinical outcomes according to OAC status. The number (incidence rate) of stroke/systemic embolism (SE) and major bleeding events during the median follow-up of 3.0 years was 224 (2.3%/year) and 177 (1.8%/year), respectively. After the release of DOAC, the prevalence of DOAC use increased gradually and steadily, and that of warfarin, DOAC and no OAC was 37%, 26% and 36%, respectively in 2015. On Cox proportional hazards modeling incorporating change in OAC status as a time-dependent covariate for stroke/SE and major bleeding events, use of DOAC compared with warfarin was not associated with stroke/SE events (HR, 0.95; 95% CI: 0.59–1.51, P=0.82) or major bleeding events (HR, 0.82; 95% CI: 0.50–1.36, P=0.45).</p><p>Conclusions:In real-world clinical practice, there were no significant differences in stroke/SE events or major bleeding events for DOAC compared with warfarin in patients with AF.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 81 (9), 1278-1285, 2017

    一般社団法人 日本循環器学会

被引用文献 (45)*注記

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